Completion sleeve pneumonectomyを施行した多発肺癌の1例

概要

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A 55-year-old man underwent right lower lobectomy in July, 1990 for squamous cell carcinoma. The postoperative diagnosis was pT1N0M0, Stage I. About one and a half years later he had bloody sputum. Bronchoscopy showed a tumor from the orifice of the right upper bronchus to the lower trachea. The histological diagnosis was squamous cell carcinoma. In March, 1991, he had completion right sleeve pneumonectomy. First, via a median sternotomy the right pulmonary artery was sectioned. Second, via left lateral thoracotomy a bronchial anastomosis was performed, followed by excision of the remaining lung. The trachea was resected 3 rings proximal to the carina, and the. left main bronchus was recected at the level of the carina. An anastomosis was then performed with interrupted sutures and was wrapped with thymus fat tissue. The post opearative course was uneventful, and the patient was discharged 50 days after operation.<BR>Completion sleeve pneumonectomy is rare by performed, and the intrapericardial approach to the right main pulmonary artery via median sternotomy is useful in preventing pulmonary artery injury.